Benefits of a Balance Exercise Assist Robot in the Cardiac Rehabilitation of Older Adults with Cardiovascular Disease: A Preliminary Study

Abstract

We examined whether adding robot-supported balance exercises to cardiac rehabilitation improves the ability to balance in older adults with cardiovascular disease (CVD). We conducted a prospective study in 52 older adults who had been hospitalized for worsening CVD. Once weekly for four months, for a total of sixteen sessions as outpatients, the subjects used a Balance Exercise Assist Robot (BEAR) to perform balance exercises and an ergometer for aerobic exercises. Participants’ mean age was 76.9 ± 6.8 years (range, 65–95 years), and their mean brain natriuretic protein level was 164.0 ± 190.0 pg/mL. After the intervention, participants showed significant improvements in gait speed (before, 1.06 ± 0.33 m/s; after, 1.23 ± 0.30 m/s; p < 0.001), Short Physical Performance Battery score (before, 10.02 ± 2.25; after, 10.88 ± 1.79; p ˂ 0.001), timed up-and-go (before, 11.11 ± 5.07 s; after, 9.45 ± 3.45 s; p ˂ 0.001), and knee extension (before, 26.97 ± 11.78 kgf; after, 30.13 ± 13.04 kgf; p = 0.001). Cardiac rehabilitation including exercises using BEAR improved physical functioning and the ability to balance in older adults with CVD. Frail and prefrail patients improved, whereas robust ones did not change.

Randomized Controlled Trial of Cardiac Rehabilitation Using the Balance Exercise Assist Robot in Older Adults with Cardiovascular Disease

“…Although there are numerous reports of the effectiveness of rehabilitation with BEAR [3,5,10,[19][20][21], there are none in patients with cardiac disease, except in our previous study, which was a single arm without a control group [4]. In the present study, CR with resistance training and using BEAR resulted in significant improvements in nutrition, physical function, and balance after 4 months, with no significant differences in the magnitude of the changes between the resistance training and BEAR groups, except for FIM motor and GNRI.…”

“…Therefore, as part of an industry-academic collaboration, we have developed the balance exercise assist robot (BEAR), a balancefocused exercise therapy, as an intervention for older adults with CVD and verified its effectiveness in preventing patient frailty, as reported elsewhere [3][4][5]. Briefly, BEAR is a stand-up-and-ride transport robot and personal mobility device with a two-wheel inverted its effectiveness in preventing patient frailty, as reported elsewhere [3][4][5]. Briefly, BEAR is a stand-up-and-ride transport robot and personal mobility device with a two-wheel inverted balance.…”

“…The BEAR (Toyota Motor Corporation, Aichi, Japan) used in the present study had two wheels, an in-wheel motor controlled by an inverted pendulum system, and a foot plate on either side (Figure 2; Supplementary Video S1), as shown in our previous study [4]. The BEAR moves backwards and forwards and left and right according to shifts in the operator's center of gravity.…”

“…Recent research has focused on the effects of on in improving the functional capacity of frail older adults [4,6]. Training with BEAR is effective in improving posture.…”

“…Training with BEAR is effective in improving posture. However, little information is available regarding the safety and efficacy of BEAR during cardiac rehabilitation (CR) in older adults with CVD [4]. Therefore, the aim of the present study was to compare the clinical safety and efficacy of postural strategy training using the BEAR system with those of conventional resistance training during CR in older adults with CVD.…”